Recent clinical studies examining existing databases such as UK Biobank or National Health and Nutrition Examination Survey (NHANES) data set using this new nomenclature revealed that the MetALD (MASLD with heavy alcohol consumption) group comprises predominantly males (66% in UK Biobank or 71% in NHANES vs. 55%–60% in MASLD controls) and have higher serum ALT and aspartate aminotransferase levels but lower incidence of diabetes and dyslipidemia compared to MASLD.38,39 However, no systematic assessment of the role of female sex and female sex hormone signaling in MetALD was performed. Here, GPT is linked to metabolic syndrome.